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CARBOHYDRATE COUNTING
Method 1
FOOD DIARY, INSULIN DOSE, AND SMBG INFORMATION
Insulin: Carbohydrate ratio = Grams of carbohydrate at a given meal ÷ number of
units of insulin taken at that meal
EXAMPLE:
1. Patient needs 4 units of insulin to cover 40 grams of carbohydrates
2. Insulin: Carbohydrate ratio = 40 ÷ 4 = 10 Ratio = 1:10 (This means that 1
unit of rapid acting insulin is needed for every 10gms of carbohydrate in a
meal)
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Method 2
THE RULE OF 500/300
Insulin: Carbohydrate ratio = 500/300 ÷ total daily insulin dose of insulin
(TDD)
EXAMPLE:
• TDD = 36 units Glucose levels are within target range
• Insulin: Carbohydrate ratio = 500 ÷ 36 = 13.8 (round up to 14) Ratio = 1:14
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Method 3
USING THE INSULIN SENSITIVITY FACTOR (ISF)
• ISF = 1700÷ Total Daily Dose of Insulin(TDD)
• Insulin: Carbohydrate ratio = ISF× 0.33 TDD
EXAMPLE:
• ISF = 1700 ÷ 25 = 68 mg/dl
• Insulin: Carbohydrate ratio = 68 × 0.33= 22.4 (round up to 22)
DETERMINING PREMEAL INSULIN DOSE
EXAMPLE:
• TDD= 34 units
• Target glucose levels = 100 mg/dl
• Premeal glucose level = 226 mg/dl
• 60 grams of carbohydrates are to be consumed
ANSWER
• ISF = 1700 ¸ 34 = 50
• Difference between target and actual glucose levels = 226 – 100 =126 mg/dl
• Correction dose = 126 ÷ 50 = 2.3 units
• Insulin : carbohydrate ratio
• 500 ÷ 34 = 14.7
• Ratio= 1:15
• Units of insulin to cover carbohydrates = 60 ÷ 15 = 4 units
Premeal insulin = 2.3 units + 4 units = 6.3 units
RATIO - 1:22
INSULIN DOSE CORRECTION
EXAMPLE:
• Glucose = 264mg/dl
• Target glucose level is 100 mg/dl
• ISF = 53 mg/dl
ANSWER
• Difference between target and actual glucose levels = 264 – 100 = 164 mg/dl
• Correction dose = 164 mg/dl ÷ 53 mg/dl = 3.1 units
The correction dose of insulin is 3 units
BASIC PRINCIPLES OF DIABETIC DIET
• HIGH FIBER (e.g. green leafy vegetables, fruits and salad)
• LOW FAT (3-4 tsp/day)
• MEALS ON TIME
• SPLIT YOUR MEALS
• TAKE SIX SMALL AND FREQUENT MEALS
• HEALTHY ROASTED AND NON FRIED SNACKS – mid morning and mid afternoon
• NO DIRECT SUGARS - sugar, honey, jaggery, jam, jellies
• CHOOSE HEALTHIEST DIET WHEN EATING OUT (FEASTING) (no maida, sweets and fried
foods)
• MEALS ON TIME
• DRINK LOT OF WATER
• REFINED FLOUR PRODUCTS
• SWEETS
• FRIED FOODS
• SKIPPING OF MEALS
• FASTING
• FREQUENT FEASTING
Remember diabetes is not a disease…….. ……… it is a condition, we can manage!!
NUTRITION LABELS
Sugar free foods
These foods have less than 0.5 grams of sugar per serving. However sugar free
does not mean carbohydrate free
No sugar added
Foods do not have any kind of sugar added during processing or packaging, and do
not contain high sugar ingredients. But remember they may still be high in
carbohydrate, so you have to check the label.
Fat Free
Foods are often higher in carbohydrate than the foods they replace, so they are
not a better choice.
ARE YOU CONFUSED?
Visit the nutrition and diabetes column.
Shweta Singh
Nutritionist and Diabetes Counselor
(M. Sc. Foods and Nutrition, CDE).
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